Culture bound syndromes: The story of Dhat syndrome

Section of Epidemiology, Institute of Psychiatry, London, UK.
The British Journal of Psychiatry (Impact Factor: 7.99). 04/2004; 184:200-9. DOI: 10.1192/bjp.184.3.200
Source: PubMed


Culture-bound syndrome is a term used to describe the uniqueness of some syndromes in specific cultures. Dhat (semen-loss anxiety) has been considered to be an exotic 'neurosis of the Orient'.
To ascertain the presence of similar symptoms and syndromes in different cultures and historical settings.
Electronic and manual literature searches were used to gather information on the existence and description of semen-loss anxiety in different cultures and settings.
Most of the empirical studies on dhat syndrome have emerged from Asia, whereas its concepts have been described historically in other cultures, including Britain, the USA and Australia. The different sources indicate the universality of symptoms and global prevalence of this condition, despite its image as a 'neurosis of the Orient'.
It appears that dhat (semen-loss anxiety) is not as culture-bound as previously thought. We propose that the concept of culture-bound syndromes should be modified in line with DSM-IV recommendations.

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Available from: Sisira H Siribaddana
    • "When we look at the findings of the present study, it is evident that Dhat syndrome as a clinical manifestation is seen in all parts of India and a significant proportion of the patients with Dhat syndrome occur without syndromal depression and anxiety disorders (Grover et al., 2015). Existing data suggest that in many countries, including those from West, semen is considered to be important for healthy functioning of male (Sumathipala et al., 2004). The core feature of Dhat syndrome, that is, fear or distress of losing semen, can be considered to be influenced by the cultural belief systems across various countries. "
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    ABSTRACT: To assess the phenomenology and associated beliefs in patients with Dhat syndrome. A total of 780 male patients aged more than 16 years were recruited from 15 centers spread across the country and were assessed on Dhat Syndrome Questionnaire. The most commonly reported reasons for passage of Dhat were excessive masturbation (55.1%), sexual dreams (47.3%), excessive sexual desire (42.8%) and consumption of high energy foods (36.7%). The most common situation in which participants experienced passage of Dhat were as 'night falls' (60.1%) and 'while passing stools' (59.5%). The most common consequence due to passage of Dhat was weakness in sexual ability (75.6%). In terms of psychological and somatic symptoms, the common symptoms included bodily weakness (78.2%); feeling tired or having low energy (75.9%); feeling down, depressed, or hopeless (67.9%); and little interest or pleasure in doing things (63.7%). In terms of treatment expectations, about half of the patients (49.1%) expected that energizing medications like vitamins/tonics/tablets were required and more than one-third (38.2%) expected that there was a need for taking energizing injections. Present study shows that Dhat syndrome is a distinct clinical entity seen all over India, with its characteristic features. © The Author(s) 2015.
    No preview · Article · Jul 2015 · International Journal of Social Psychiatry
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    • "Syndromes similar to dhat have been reported from China, Sri Lanka, Europe, Americas, and Russia at different points of time in history.[4] Similarly, latah (from Malayo-Indonesia) and imu (from Japan) have been considered by researchers to be behaviorally matching.[8] "
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    ABSTRACT: Dhat syndrome is described as a culture bound syndrome (CBS). There is an ongoing debate on the nosological status of CBS. Dhat syndrome has been found to be prevalent in different geographical regions of the world. It has been described in literature from China, Europe, Americas, and Russia at different points of time in history. Mention of semen as a "soul substance" could be found in the works of Galen and Aristotle who have explained the physical and psychological features associated with its loss. However, the current classification systems such as International Statistical Classification of Diseases and Related Health Conditions-10 (ICD-10) (World Health Organization (WHO)) and Diagnostic and Statistical Manual (DSM)-IV-TR (American Psychiatric Association) do not give guidelines to diagnose these culture-bound conditions in the main text. The revisions of these two most commonly used nosological systems (the ICD and DSM) are due in near future. The status of this condition in these upcoming revisions is likely to have important implications. The article reviews the existing literature on dhat syndrome.
    Full-text · Article · Mar 2013 · Indian Journal of Psychological Medicine
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    • "ideals remains an issue of debate and contention (Ferguson et al. 2011b; Levine and Murnen 2009). According to Sumathipala et al. (2004, p. 200), ''[c]ulture-bound syndrome is a term used to describe the uniqueness of some syndromes in specific cultures.'' However, Grabe et al. (2008) point out that increased incidence of eating disorders across the early and mid-twentieth century seem to coincide with trends in the media toward emphasizing thinness in women. "
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    ABSTRACT: The degree to which media contributes to body dissatisfaction, life satisfaction and eating disorder symptoms in teenage girls continues to be debated. The current study examines television, social media and peer competition influences on body dissatisfaction, eating disorder symptoms and life satisfaction in a sample of 237 mostly Hispanic girls. 101 of these girls were reassessed in a later 6-month follow-up. Neither television exposure to thin ideal media nor social media predicted negative outcomes either concurrently nor prospectively with the exception of a small concurrent correlation between social media use and life satisfaction. Social media use was found to contribute to later peer competition in prospective analysis, however, suggesting potential indirect but not direct effects on body related outcomes. Peer competition proved to be a moderate strong predictor of negative outcomes both concurrently and prospectively. It is concluded that the negative influences of social comparison are focused on peers rather than television or social media exposure.
    Full-text · Article · Jan 2013 · Journal of Youth and Adolescence
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